New Legislation Will Change USFHP Eligibility

The U.S. government recently passed an act that will affect US Family Health Plan. It will change who can join US Family Health Plan and how long new members can stay in the plan. The act is called the National Defense Authorization Act.

Important! The act does not affect current members of US Family Health Plan. It also does not affect people who join the plan before October 1, 2012. All of these members can remain in the plan for life, regardless of age.

September 30, 2012, is an important deadline.* USFHP can accept new members of any age through September 30. They can stay in the plan for life, regardless of their age. After the deadline, USFHP can only accept people who are younger than 65. New members who join after the deadline will have to leave the plan when they turn 65.

What does that mean for military beneficiaries? Here are the key changes:

  • Military retirees who are age 65 or older: After the deadline, you will not be permitted to join USFHP.
  • Military retirees who are under age 65: If you enroll in USFHP after the deadline, you will lose eligibility at age 65. When you turn 65, you will need to leave the plan. You will be required to transition to Medicare. TRICARE For Life will then be your Medicare supplement.
  • Active duty family members who are under age 65: If you enroll in USFHP after the deadline, you will lose eligibility at age 65. When you turn 65, you will need to leave the plan. You will be required to transition to Medicare. TRICARE For Life will then be your Medicare supplement.

Don’t wait until the last minute. To be a member for life, you must have an effective date of coverage that is on or before September 30, 2012.*

*If you are covered now by TRICARE Standard or TRICARE For Life, you have an earlier deadline. It is August 20, 2012.

Our Members Give USFHP the Highest Marks

US Family Health Plan is the highest rated health care plan in the Military Health System. An impressive 91% of members report high satisfaction. That is 45% higher than the national average of health plans.

USFHP Is Committed to Military Families

We are Pacific Medical Centers, a Designated Provider of the TRICARE Prime benefit. For over 30 years, we have proudly provided healthcare to Northwest military families. We look forward to continuing to bring you superior customer service and easy access to care.

Learn More

How will the National Defense Authorization Act affect you? Learn more at these resources:

  • Read our Q&A section below. It speaks to both current members and future members.
  • Still have questions? Call us at 1 (866) 418-7347.

Q&A about the New Legislation

If the information you need is not here, please call our marketing team at 1 (866) 418-7347.

Current USFHP Members

Am I still eligible? Will I lose eligibility?

Current members are not affected by the legislation. You may remain a member of US Family Health Plan as long as you like, regardless of age. If you leave the plan, however, you will not be able to reenroll after September 30, 2012, if you are 65 or older.

What does the new legislation mean?

It is called the National Defense Authorization Act. One part of it affects who is eligible for US Family Health Plan. These changes take effect on October 1, 2012. The act says that members who join USFHP after September 30, 2012, must leave when they turn 65. Also, anyone who is 65 or older may not join the plan after September 30.

What do I have to do?

No action is required if you are currently a member of US Family Health Plan. If your coverage started on or before September 30, 2012, you may stay in the plan.

My spouse is currently a USFHP member and is not yet 65. Can my spouse stay in the plan?

Yes. And we encourage your spouse to stay in the plan. That way, he or she can remain a member at age 65 and beyond.

Prospective Members

I am not yet a member of US Family Health Plan. What do I have to do?

Anyone who wants to join must be listed in DEERS as eligible for military health benefits. You should become familiar with US Family Health Plan and decide if it’s the right choice for you. If it is, enroll before September 30, 2012, to be eligible for life.

I am enrolled in Medicare. Can I still enroll?

Yes, you can still enroll in US Family Health Plan. We encourage you to take action soon. You must have an effective coverage date on or before September 30, 2012. After that date, anyone who is 65 will no longer be allowed to join USFHP.

I turn 65 soon. Can I still enroll?

If you enroll before September 30, 2012, your age does not matter. After that date, anyone who is 65 will no longer be allowed to join USFHP.

About three or four months before your birthday month, you should receive a letter from the DoD/TMA. It will alert you to enroll in Medicare Part B so that you can keep your TRICARE eligibility. However, if you join USFHP before you turn 65, you can stay in the plan after you turn 65, with or without Medicare Part B. You must enroll before September 30, 2012.

How is US Family Health Plan different from TRICARE For Life (TFL)?

TRICARE For Life is a Medicare supplement. You must enroll in Medicare Part B in order to be eligible for TFL. Medicare and TFL allow you to go to any doctor at any facility as long as they accept Medicare or TFL. With TFL, you may have to arrange your own care and make sure it is coordinated.

US Family Health Plan is a special TRICARE Prime program. Because it is a managed care plan, your primary care provider will arrange and coordinate your care with other doctors. You’ll receive all your care within the US Family Health Plan network. Also, you will fill all of your prescriptions only through a USFHP network pharmacy.

US Family Health Plan offers more benefits than Medicare and TRICARE for Life combined. As a US Family Health Plan member, you will have:

  • The option to delay or decline Medicare Part B enrollment at age 65.
  • A fully covered preventive eye exam each year.
  • Fully covered hospital and skilled nursing stays without time limits. (This is a skilled nursing benefit and not a long term care or custodial care benefit.)
  • Predictable costs without “balance billing” or confusing paperwork.
  • Worldwide coverage when you travel.
  • Discounts on many services not covered by TRICARE or Medicare.

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